Sports and Recreation Eye Injury Expert

How the injuries happen

• Ball and puck impact. Small, dense projectiles such as baseballs, softballs, racquetballs, squash balls, golf balls and pucks fit the orbital opening and deliver their energy to the globe. Larger balls are more likely to strike the orbital rim. Findings range from hyphema and angle recession to retinal tears, choroidal rupture and globe rupture.
• Racquet, stick, bat and elbow injuries cause blunt trauma and orbital fractures; hockey sticks and lacrosse sticks are classic sources of lid and brow lacerations.
• Fishing hooks and elastic cords cause penetrating injury; bungee cords and elastic tie-downs that snap back are a well-recognized cause of severe blunt injury.
• Paintball, airsoft and BB guns produce a high rate of serious injury when eyes are unprotected; the small, fast projectile can rupture the globe.
• Fireworks combine blast, burn and fragment injury, often to bystanders.
• Swimming and diving injuries are usually surface irritation, but a diving impact can produce the same blunt injuries as any other collision.

Protective eyewear and standards

Sports eye protection is tested to published performance standards, and helmets and face shields to their own. Whether appropriate protection was required by the league or facility, provided, worn and in usable condition is a liability question for counsel; whether the eyewear that was worn could have prevented the specific injury is a question an ophthalmologist can address from the mechanism and the findings. Ordinary eyeglasses and contact lenses are not protective, and street eyeglasses can shatter and add laceration injury to the impact.

The medical questions in litigation

• Initial evaluation. Was a hyphema managed correctly, was the pressure checked, was a dilated examination performed to look for retinal tears, and was an open globe recognized before manipulation?
• Causation of later problems. Angle-recession glaucoma, traumatic cataract and retinal detachment can surface long after the game. The examination findings documented at the time of injury are what connect them.
• Pre-existing conditions. High myopia, lattice degeneration, amblyopia and prior injury all affect both causation and damages.
• Impairment and prognosis. Best-corrected acuity, visual fields and diplopia are rated under the AMA Guides framework. See Visual Disability Evaluation and Ophthalmic Prognosis.

Who retains an expert in these matters

Plaintiff and defense counsel in premises liability and negligence suits against facilities, leagues and schools; product liability counsel where eyewear, equipment or a projectile is alleged to be defective; insurers evaluating claims; and, in workplace recreation or professional sport, workers’ compensation parties. The analysis does not change with the retaining party.

What attorneys should gather

Incident and witness reports, the equipment and eyewear involved (or photographs of it), any league or facility rules on eye protection, emergency and ophthalmology records from the first visit onward, prior optometry records for baseline vision, and imaging in native format. The general checklist is at Attorney Checklist for Eye Injury Cases.

Frequently Asked Questions

Authorities Cited

Primary sources referenced on this page. Links open the official text on the publishing agency’s site.

• American Medical Association, Guides to the Evaluation of Permanent Impairment (program page)